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Abstract

Introduction: Cardiac arrest survivors often suffer from cognitive deficits. Locally, the Computer Assessment of Mild Cognitive Impairment (CAMCI), a 100-point scale, is used to evaluate such deficits. ICU admission without acute brain injury is also associated with cognitive deficits, suggesting these deficits may be due to other components of hospitalization.

We hypothesized that cognitive deficits are associated with length of coma, length of ICU stay, days post ICU stay to testing, and initial illness severity as measured by the Pittsburgh Cardiac Arrest Category (PCAC) Score.

Methods: We reviewed our database between 2010-2016 for PCAC Score, time to first follow commands, time to ICU discharge, number of days post ICU stay to CAMCI, and CAMCI score. Associations between CAMCI scores, illness severity, familiarity with technology, and treatment time intervals were examined using uni- and multivariable regression.

Results: We reviewed 151 cases; 86 were male (57%) with mean age of 55 (SD 14) years. CAMCI scores ranged from 0 to 78 (median 31, IQR 13-47). [See Table 1] CAMCI score was associated with age (p= 0.014), computer familiarity (p=0.007), and ATM familiarity (p=0.059). When adjusted for computer or ATM familiarity, age was not related to CAMCI score. Elderly patients were less likely to use ATMs or computers. CAMCI score was not related to PCAC, ICU length of stay, duration of coma, or number of post ICU recovery days prior to testing.

Discussion: Significant variation in CAMCI scores are associated with ATM or computer familiarity. This may explain why age has been associated with lower CAMCI scores in prior cohorts. Cognitive deficits are not associated with duration of coma, ICU length of stay, or timing of cognitive testing. Caution is warranted when interpreting CAMCI testing in elderly patients who have limited computer familiarity.